G6PD Deficiency

G6PD deficiency reduces energy available to maintain the integrity of the red cell membrane, which shortens RBC survival.Hemolysis selectively, affects older RBCs among affected blacks and among most affected whites. Hemolysis occurs commonly after fever, acute viral and bacterial infections, and diabetic acidosis. Less commonly, hemolysis occurs after exposure to drugs or to other substances that produce peroxide and cause oxidation of Hb and RBC membranes.
Whether continued use of the offending drug leads to a compensated hemolytic state or lethal hemolysis depends on the degree of G6PD deficiency and the oxidant potential of the drug. Chronic congenital hemolysis (without drug use) occurs in some whites. Because older cells are selectively destroyed in blacks, hemolysis is usually self-limited, affecting < 25% of RBC mass; in whites, the deficiency is more severe, and profound hemolysis may lead to hemoglobinuria and acute renal failure.